Mary Galea and Aurora Messina, University Melbourne, Melbourne, Australia

Reversing peripheral nerve dysfunction using functional electrical stimulation

Funded in: 2020, 2021, 2022


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Problem: Does functional electrical stimulation (FES) reverse the abnormalities and improve the health of the peripheral nerves?
Target: Insights about the mechanisms underlying the effects of FES on the peripheral nerves
Goal: This study will provide a sound basis for the use of FES in people with SCI

Introduction: The abrupt loss of nervous system activity after spinal cord injury (SCI) disrupts communication between nerve fibres and the myelin-producing Schwann cells that support them, leading to abnormalities such as myelin thickening and folding. Increasing the level of activation along the nerves may reverse these changes.
Problem: Does increasing the activation along the peripheral nerves using functional electrical stimulation (FES) reverse the abnormalities and improve the health of the nerves?
Methods: Nerve transfer surgery presents a novel, unique and rare opportunity to obtain samples of multiple peripheral nerves without causing further injury to patients. Direct assessment of the nerves under the microscope is essential to properly describe any abnormalities and to better understand the causes of deficits identified using more indirect methods. The researchers will take samples of peripheral nerves from participants undergoing nerve transfer surgery, comparing the nerves of those who have pre-operative FES with those of participants who have previously undergone nerve transfer surgery but without pre-operative FES (historical controls).
Expected results: This research will provide new information about the mechanisms underlying the effects of FES on the peripheral nerves in people with SCI. Understanding the mechanism of action of FES adds to the evidence base for its use.
Potential application: FES is a technique already available clinically. New knowledge from this study will be applicable to most people with SCI. If the provision of FES is found to reverse the myelin abnormalities, this study will provide a sound basis for the use of FES to improve the health and integrity of the peripheral nerves in people with SCI.